Your doctor may check your weight, blood pressure, cholesterol and other standard health risk factors at your annual checkup. But if you’re not being asked about your mood, an important predictor of health problems is being overlooked.
In a study published recently in Health Psychology researchers found that depression and anxiety may be leading predictors of conditions such as high blood pressure, heart disease, headaches, arthritis, and many others.
The findings reinforce previous studies that linked mood disorders to poor physical health, yet this connection is often overlooked in conversations between individuals and their physicians. The researchers suggest that the risks of anxiety or depression are every bit as serious as smoking or obesity.
Though he was not involved in this study, psychiatrist Jeff Huffman, MD, director of the Cardiac Psychiatry Research Program at Massachusetts General Hospital, agrees that addressing mood disorders effectively may go a long way in preserving heart health and physical health, in general.
“It’s hard to overestimate the effects of depression on health,” Dr. Huffman says. “For example, after a heart attack, people who are depressed are almost twice as likely to be dead in the next year. And the relationship between depression and adverse heart outcomes is independent of age, gender, and other medical conditionsÑit is considered now a cardiac risk factor, like high blood pressure or diabetes.”
How Mood Affects Health
In the study of more than 15,000 adults, researchers found that those with high levels of anxiety and depression were 65 percent more likely to develop heart disease, 64 percent more likely to have a stroke, 50 percent more likely to develop high blood pressure, and 87 percent more likely to have arthritis compared to people without anxiety and depression. The increased odds were similar to those among people who smoked or who were obese.
Symptoms such as headache, stomach ache, and back pain were also much more common among people experiencing stress and depression.
Interestingly, mood disorders were not associated with higher risks of cancer, according to the study. Other studies have found that, despite the commonly held belief to the contrary, stress and depression aren’t reliable cancer predictors.
Still, your mood can affect your health in multiple ways. Being depressed, for example, can mean you are less motivated to be physically active and take care of yourself. Being sedentary is a common symptom of depression. Depression and anxiety can lead to unhealthy weight gain or weight loss, poor sleep, and less social engagement with friends and familyÑall of which are strongly associated with poor health outcomes.
“Certainly it looks like depression or anxiety, but especially depression, are associated with less engagement in a wide range of healthy behaviors, from exercise to healthy eating to quitting smoking to taking medication regularly,” Dr. Huffman says. “The link with exercise is important, but it looks like these mental health conditions can have broad effects on behavior.”
He adds that mood disorders have biological effects on the “fight-or-flight” nervous system that can lead to increased inflammation and obesity. “This makes it much harder to take on healthy behavior change, like starting to exercise or stopping smoking,” Dr. Huffman says. “So it’s both biology and behavior/motivation.”
Good Mood, Better Health
“On the flip side,” Dr. Huffman adds, “optimism and happiness are both associated with superior healthÑpeople who have a more optimistic outlook experience more happiness and are less likely to become ill or to have progression of their illness.”
Just as people struggling with depression or anxiety tend to be less active and more inclined toward an unhealthy lifestyle, individuals who are generally more relaxed and have a positive attitude are more likely to exercise regularly, eat healthy foods, and avoid reckless and unhealthy behaviors, such as smoking and drinking to excess. Someone with a strong sense of purpose in life is more likely to have regular medical checkups and follow his or her physician’s advice.
In a 2018 report published in the Journal of the American College of Cardiology (JACC), Dr. Huffman and colleagues wrote that a growing body of evidence suggests that “positive psychological well-beingÑwhich includes positive thoughts and feelings such as purpose in life, optimism, and happinessÑhas its own independent associations with lower risk of cardiovascular disease and may promote cardiovascular health.”
Though the Health Psychology study didn’t explore the possible health benefits of treating anxiety or depression, there is plenty of research suggesting that positive health outcomes can result from psychological interventions for people dealing with mood disorders. In the JACC report, Dr. Huffman and other researchers note that studies have shown mindfulness interventions (such as tai chi and yoga) were associated with better outcomes for heart failure patients, and psychology interventions that focused on boosting optimism in people with cardiovascular disease also led to improvements in psychological well-being and in physical function.
If you need another reason to address low mood and signs of depression or anxiety, consider that your physical health may improve right along with your emotional outlook.
Start the Conversation
If your doctor doesn’t ask you about your mood, you shouldn’t hesitate to bring up any changes that you’ve noticed. Mood disorders can develop gradually, often making it difficult for individuals to recognize changes in themselves. If you sense a change or a loved one has raised the subject, consider talking with your doctor.
Not only will it be something your physician can note on your medical records as a condition to monitor moving forward, but it can be a way to start addressing the issue or issues. Your doctor may refer you to resources in your community or to a specific mental health professional or practice. Or, your doctor may start treating you.
“I think you could say to a doctor something as simple as, ‘I have been feeling down and depressed and I think it’s getting in the way of my life, health, function,’ or whatever applies to you,” Dr. Huffman says. “It turns out that primary care physicians are the leading prescribers of antidepressants, so they are very, very used to talking to people about depression.”
And if you don’t want to start a conversation with your physician, look for a mental health professional with whom you feel comfortable. People often put off therapy because of embarrassment or uncertainty about where to begin. But getting started with someone is the key, and it may be the thing that helps keep your heart pumping and helps keep you feeling better physically for a long time.